Speech Recovery Research Articles

The role of connected speech in distinguishing types of apraxia of speech following brain damage

Apraxia of speech (AOS) is a common condition resulting from brain damage causing impairments to speech planning and programming that is distinct from aphasia and dysarthria. Following a stroke, AOS is most often seen as a part of nonfluent Broca’s aphasia. Recovery and dissolution of speech in stroke induced apraxia of speech (sAOS) and progressive AOS (pAOS) appear on a symptomatic level to be reversals of each other, but the existing evidence shows that sAOS is distinct from pAOS. This suggests different causes that have relevance for management of pAOS. In this article, we examine the similarities and differences between sAOS and pAOS and conclude that while the two conditions present similarly, certain features differ significantly, which may suggest different mechanisms underlying their manifestation. The role of connected speech as opposed to single word utterances is noted.

A systematic review of melodic intonation therapy used by speech therapists on speech recovery for patients with non-fluent aphasia

Background: Many studies have reported positive results regarding the benefits of melodic intonation therapy (MIT) in patients with non-fluent aphasia. Currently, there is no specific inclusion of speech therapists (STs) in MIT research. Investigating effective speech therapy (ST) techniques to address the language functions hindered by non-fluent aphasia could yield evidence for aphasia rehabilitation research. Objective: This systematic review (SR) examines the effectiveness of the traditional MIT protocol used by STs on speech recovery for patients with non-fluent aphasia after stroke. It also discusses other characteristics of the traditional MIT, such as the participants, the MIT protocol applied, the therapy intensity, and the role of STs. Materials and methods: This SR followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 statement. The four computerized databases (PubMed, Embase, ICTRP, and Google Scholar) were searched in February 2024 to review all empirical findings. We also conducted a hand search in relevant journals. The search yielded 538 studies, of which 2 met the criteria and underwent review. The methodological quality of the included studies was evaluated using the Cochrane Collaboration’s tool for assessing the risk of bias. Furthermore, the protocol was registered in PROSPERO under the reference CRD42024508733. Results: This review included 2 randomized controlled trials (RCTs) involving 44 patients. We found evidence that MIT significantly improved speech recovery, precise language repetition, and functional communication in patients with non-fluent aphasia. STs were interventionists in MIT research and used MIT following the American manual, and they had previously received MIT training. Conclusion: Our review provides some evidence of the effectiveness of MIT on speech recovery in patients with non-fluent aphasia after stroke. MIT may be a practical alternative to standard ST. There is some indication that MIT requires music therapy (MT) skills and training; therefore, STs must also have these abilities.

The use of a computer-based program focused on the syllabic method to support early literacy in children with cochlear implants

BackgroundChildren with cochlear implants (CIs) often lag behind children with normal hearing (NH) in early literacy skills. Furthermore, the development of language skills associated with their emergent literacy skills seems to depend on good auditory access. Supporting language acquisition and early literacy in children with CIs may prevent difficulties in primary school. The use of technology may facilitate auditory and speech recovery in children with CIs, but evidence on computer-based early literacy programs is limited. ObjectiveThis study investigates (a) the effects of a computer-based program focusing on the syllabic method on the literacy skills of children with CIs (CIs group), comparing them with the literacy skills of a group of age-matched NH (normal hearing) peers (NHs group); (b) the associations between language and early literacy skills in the NHs group and between language, auditory and early literacy skills in the CIs group. MethodNine prelingually deaf children with CIs (M = 61.11, SD = 6.90) with severe to profound sensorineural hearing loss and nine age-matched NH children participated in the program. Categories of Auditory Performance (CAP) as measures of children's auditory skills were collected. All participants were tested on phonological, morphosyntax (grammatical comprehension and repetition), and early literacy skills (syllable blending and segmentation, syllable and word reading) (T1). Next, all children participated in the computer-based program for 12 weeks. After the program was completed (T2), only early literacy tests were administered to the children. ResultsAlthough, on average, both groups obtained higher scores in all literacy tasks at T2, the CIs group scored lower than the NHs group. In the CIs group, at T2 we found significant improvements in syllable segmentation (p = 0.042) and word reading (p = 0.035). In the NHs group, at T2 we found significant improvements in syllable segmentation (p = 0.034), syllable blending (p = 0.022), syllable reading (p = 0.008), and word reading (p = 0.009). We also found significant associations in both groups between measures of morphosyntax at T1 and measures of early literacy at T2. In addition, for the CIs group, we found significant associations between children's auditory performance at T1 and measures of morphosyntax at T1 and early literacy at T2. Conclusiona computer-based program focused on the syllabic method could support children with CIs in acquiring emergent literacy abilities. The auditory performance of children with CIs seems to influence their morphosyntax and later early literacy skills.

Online bone/air-conducted speech fusion in the presence of strong narrowband noise

Online adaptive bone/air-conducted speech fusion is a very promising and attractive technique for real time speech communication in noisy environments. This paper firstly demonstrates that conventional bone/air-conducted speech fusion systems may degrade significantly, despite that only a tiny narrowband noise pollution persists in bone-conducted speech by extensive simulations and experiments. To address this issue, a robust nonlinear system is proposed that successfully enhances the speech contaminated by the harsh narrowband noise. The penetrated narrowband noise is extracted by an adaptive linear prediction filter from an extra reference signal that is capture by a non-contacted bone sensor, and then fed to the parallel adaptive noise cancellers to reconstruct a cleaner error feedback for the speech recovery system. Due to this combination, the proposed system enjoys both attractive robustness against the harsh additive noise and strong real-time capability. Simulations as well as application to a real factory noise are conducted to demonstrate the superior performance of the proposed system.

Current Rehabilitative Concepts in Ear Nose and Throat Department, University of Medical Sciences Teaching Hospital (UNIMEDTH): Challenges Encountered

Introduction: Unaddressed communication disorders are multidimensional, affecting individuals physiologically, psychologically and emotionally. The quality of life of these individuals can be improved with rehabilitative measures, justifying this study. The study therefore aims to assess the impact of rehabilitation on these patients, determine the challenges and proffer possible solutions. Methods: Eighteen months prospective study on audiological and speech disorders among ENT patients in the University of Medical Sciences Teaching Hospital, Ondo State, from April 2021 to September 2022 was carried out. History was taken, general examination and full E.N.T. examinations were done. Those with audiological disorders from canal blockage due to foreign bodies, debris and impacted wax had ear syringing. Others with persistent audiological condition were further evaluated and treated accordingly, with Hearing Aids trial and fitting inclusive. Patients with speech disorder had speech therapy after baseline audiological screening. Data were represented in tables and figures. P value < 0.05 was statistically significant. Results: 930 patients presented at the ENT clinic. 537 (57.74%) females and 393 (42.26%) males. Of this, 405 (43.55%) patients had audiological conditions while 23 (2.47%) had speech disorders. Impacted wax, tinnitus, hearing loss, foreign body in the ear and delayed speech development were commonest. 297 had syringing while 105 patients were further evaluated. 369 of 405 patients were successfully rehabilitated. 3 stroke patients had good speech recovery. Predominant challenges encountered were unavailability of instruments and uncooperativeness of elderly patients. Weekly savings and incorporation of dedicated relatives for home therapy ensures solutions respectively. Conclusion: Rehabilitation in E.N.T., though gradually progressive, is beneficial. The guiding concept is patience.

Auditory and speech outcomes of cochlear implantation in patients with Waardenburg syndrome: a meta-analysis.

This study aims to assess the potential efficacy of cochlear implantation as a treatment for patients with Waardenburg syndrome (WS) and to guide clinical work by comparing the effect of auditory and speech recovery after cochlear implantation in patients with WS and non-WS. PubMed, the Cochrane Library, CNKI, and Wanfang Data were sources for retrieving literature on cochlear implantation in WS, and clinical data meeting the inclusion criteria were meta-analyzed using RevMan5.41. A total of nine articles were included in this study, including 132 patients with WS and 815 patients in the control group. Meta-analysis showed that there are no significant differences in the scores for categories of audit performance (CAP), speech intelligibility rating (SIR), and parents' evaluation of aural/oral performance of children (PEACH) between the WS group and the control group. Cochlear implantation demonstrates comparable auditory and speech recovery outcomes for WS patients and non-WS patients.

Poetry as a rehabilitatory intervention for speech recovery in patients with diffuse axonal injury

Poetry as a rehabilitatory intervention for speech recovery in patients with diffuse axonal injury

Features of speech disorders in patients with acute ischemic stroke

Introduction. Various speech disorders that lead to impaired communication occur in 3050% of ischemic stroke (IS) survivors. Although most attention is traditionally paid to aphasia, speech disorders also include the following: dysarthria, dysphonia (isolated or in combination with dysarthria and/or dysphagia), fluency disorders, and non-specific speech disorders associated with the severity of condition and a cognitive disorder.
 Objective: to study the variety of speech disorders and their features in patients with acute IS.
 Materials and methods. We examined 69 right-handed patients with mild-to-moderate acute IS and NIHSS score of 412. The patients were enrolled in the study on days 17 of the IS.
 Results. We found aphasia in 27/69 patients (39.1%), dysarthria in 21/69 patients (30.4%), dysphonia (isolated or in combination with dysarthria) in 17/69 patients (24.6%), fluency disorders in 19/69 patients (27.5%; 2 patients with tachylalia and 17 patients with bradylalia). In addition, 30 patients (43.5%) had dysphagia (isolated or in combination with dysarthria). At the initial examination, patients admitted within the 17 days of the acute IS onset presented with global or severe sensory and motor aphasia. At the same time, we discovered a pronounced positive dynamics in speech recovery thanks to speech therapy sessions. A significant remission in a speech disorder component led to the development of cortical aphasia affecting either anterior or posterior language areas at the end of the most acute IS period, while aphasia severity reduced to mild or moderate.
 Conclusions. A fast reduction in aphasic disorders due to the speech therapy sessions suggests that the focal and connectional diaschisis are the basis for the severe speech disorders.

TaBE: Decoupling spatial and spectral processing with Taylor’s unfolding method in the beamspace domain for multi-channel speech enhancement

In recent years, significant advancements have been made in neural beamforming, leveraging spectral and spatial cues to enhance their performance in multi-channel speech enhancement. When the frame-wise processing mechanism is required, there exists a trade-off between performance and algorithmic delay for existing all-neural beamformers. However, from the perspective of multi-source information fusion, the network is often encapsulated into a black box to entangle and fuse the spatial and spectral features into a non-linear feature space, which hinders our understanding of how they work collaboratively for target speech extraction. In this regard, this paper proposes to decouple the spatial and spectral domain processing inspired by Taylor’s approximation theory. Specifically, we reformulate the time-variant beamforming defined in the spatial domain into the adaptive weighting and mixing of different beam components in the beamspace domain. This reformulation enables us to model the recovery of target speech as a weighted sum operation in the beamspace domain, where each beam component is associated with an introduced unknown term for residual interference cancellation. By virtue of Taylor’s series expansion, the recovery process can be decomposed into the superimposition of the 0th-order non-derivative and high-order derivative terms, where the former acts as spatial filtering in the spatial domain, and the latter serves as a residual interference canceller in the spectral domain. We conduct extensive experiments on the spatialized LibriSpeech and L3DAS Challenge datasets. Experimental results show that, compared with existing advanced approaches, the proposed method not only achieves competitive performance in terms of multiple objective metrics but also provides feasible guidance in multi-channel speech enhancement pipeline design.

The outcome of using zolpidem for treatment of postoperative posterior fossa syndrome in children with brain tumor

Abstract Introduction: At present, there is no supporting evidence-based therapy of proven efficacy to treat posterior fossa syndrome (PFS) after surgical resection of posterior fossa tumors in children where only 22% of patients may experience a full recovery. However, zolpidem, a nonbenzodiazepine hypnotics drug, seems to be a possible treatment option for PFS symptoms. Methods and Materials: This was a retrospective chart review for all children with brain tumors younger than 15 years diagnosed with confirmed PFS after surgical resection at King Abdulaziz Medical City, Jeddah, and received zolpidem to alleviate the PFS symptoms between May 2016 and April 2019. Results: A total of 6 pediatric patients who experienced PFS symptoms (median of 4 days, range 1–7 days) were included. The most commonly observed symptoms were irritability, hypotonia, swallowing deficit, unsteady walking, and delayed speech. To alleviate the PFS symptoms, zolpidem was commenced 2–5 days postoperatively. The median duration of use was 13.5 days. During the hospital course, recovery of speech was observed after 2 weeks in most patients (50%) while 83.3% of patients recovered their normal speech in 4 months although not fully ambulated. No discontinuation of zolpidem use was reported because of adverse events. Conclusion: Most of our children (83.3%) who experienced PFS postresection responded to zolpidem trials which may represent a promising research field.

Cerebellar mutism is linked to midbrain volatility and desynchronization from speech cortices.

Cerebellar mutism syndrome is a disorder of speech, movement and affect that can occur after tumour removal from the posterior fossa. Projections from the fastigial nuclei to the periaqueductal grey area were recently implicated in its pathogenesis, but the functional consequences of damaging these projections remain poorly understood. Here, we examine functional MRI data from patients treated for medulloblastoma to identify functional changes in key brain areas that comprise the motor system for speech, which occur along the timeline of acute speech impairment in cerebellar mutism syndrome. One hundred and twenty-four participants, all with medulloblastoma, contributed to the study: 45 with cerebellar mutism syndrome, 11 patients with severe postoperative deficits other than mutism, and 68 without either (asymptomatic). We first performed a data-driven parcellation to spatially define functional nodes relevant to the cohort that align with brain regions critical for the motor control of speech. We then estimated functional connectivity between these nodes during the initial postoperative imaging sessions to identify functional deficits associated with the acute phase of the disorder. We further analysed how functional connectivity changed over time within a subset of participants that had suitable imaging acquired over the course of recovery. Signal dispersion was also measured in the periaqueductal grey area and red nuclei to estimate activity in midbrain regions considered key targets of the cerebellum with suspected involvement in cerebellar mutism pathogenesis. We found evidence of periaqueductal grey dysfunction in the acute phase of the disorder, with abnormal volatility and desynchronization with neocortical language nodes. Functional connectivity with periaqueductal grey was restored in imaging sessions that occurred after speech recovery and was further shown to be increased with left dorsolateral prefrontal cortex. The amygdalae were also broadly hyperconnected with neocortical nodes in the acute phase. Stable connectivity differences between groups were broadly present throughout the cerebrum, and one of the most substantial differences-between Broca's area and the supplementary motor area-was found to be inversely related to cerebellar outflow pathway damage in the mutism group. These results reveal systemic changes in the speech motor system of patients with mutism, centred on limbic areas tasked with the control of phonation. These findings provide further support for the hypothesis that periaqueductal grey dysfunction (following cerebellar surgical injury) contributes to the transient postoperative non-verbal episode commonly observed in cerebellar mutism syndrome but highlights a potential role of intact cerebellocortical projections in chronic features of the disorder.

OPPORTUNITIES FOR SPEECH RESTORATION IN PATIENTS WITH MAXILLECTOMY. LITERATURE REVIEW

Background: Over the last few years, there has been an increase in oncologic morbidity in the maxillofacial region. A significant increase in cases of cancer of the maxilla has been established. As a result of the surgical treatment of maxillary tumours, the barrier between the oral and nasal cavity is broken, which leads to serious speech disorders. Aim: The purpose of the literature review is to analyse data from different studies on the changes in speech after maxillectomy and the opportunities for its restoration with different types of dentures. Discussion: The opportunities for treatment of patients with maxillary defects include surgical restoration or obturator, as there are contradictory data on what are the optimal means of restoring speech. The predominant opinion is that the choice of treatment method depends on the size and the location of the defects, with most authors considering obturators the optimal means of treatment. Their role in the normalisation of speech function by restoring the barrier between the oral and nasal cavity is indisputably proven. Immediate prosthetics have been found to provide faster and easier recovery of speech. To preserve the achieved results, a three-stage method of treatment with surgical, temporary and definitive obturator is recommended, which restores not only speech but also normal articulation. Conclusion: Surgical treatment of cancer of the upper jaw causes defects differing in size, which seriously disturbs speech function. Depending on the size and location of the defect, specific prosthetic treatment methods are used, with different types of dentures being produced.

Teaching NeuroImages: Hemimeningitis mimicking acute ischemic stroke

A 78-year-old man with sudden-onset right-sided weakness and mutism had no history of fever, seizures, or headache. On examination, abulia, transcortical motor aphasia, and right dense hemiplegia were noted. Contrast-enhanced brain MRI suggested meningitis (figure 1) and ruled out stroke (figure 2). On CSF analysis, lymphocytic (94%) pleocytosis (163 cells/mm3), abundant Gram-positive cocci, and hyperproteinorrachy (48 mg/dL) with normal CSF:serum glucose ratio were noted. After 14 days of ceftriaxone plus vancomycin and recovery of hemiparesis (MRC 4/5), speech (improved fluency), and CSF–pleocytosis resolution (2 cells/mm3), the patient was discharged. Localized meningitis is rare. We found 2 reports: one stroke mimic1 and another associated with necrotizing vasculitis.2

Правое полушарие и восстановление речи при постинсультной афазии

<p style="text-align: justify;">The analytical review presents the clinical, neurobiological, and neuropsychological aspects of post-stroke aphasia as well as the role of the right hemisphere in speech recovery. The paper shows the influence of size, topography, lesion depth, cerebral hemodynamic plasticity, initial morphometric characteristics of the brain, and handedness on the functional recovery of aphasia. The review considers the typology and mechanisms of the appearance of "stealing symptoms" of homologous and non-homologous regions of the intact hemisphere. The "low-level" and "high-level" models of language competence of the right hemisphere are analyzed. The study describes the topography of the brain activation regions in the intact hemisphere during various speech task-solving. The paper shows the heterochrony between impressive and expressive speech recovery in aphasics and its bilateral inter-lateral distribution. The authors conclude that to clarify the mechanisms of aphasia recovery, it is necessary for a comprehensive account of clinical, neurobiological and neuropsychological patterns of speech disorder reparation in different post-stoke epochs. The paper notices that a deeper understanding of the impact of structural and functional repairment of speech processes on the aphasia outcome, it needs to assess the relationship between the degree of speech disorders reduction and the lateral vector of speech architectonics in the post-stroke period.</p>

Relationship between upper extremities functional recovery with speech recovery among post stroke patients - an observational study

Globally stroke is one of the most common neurological disease, frequently causing death and disability. The survivors suffer from various impairments among which upper and lower limb motor deficits, visuo-spatial neglect and speech impairments are most common. The aim of the study is to find out the association between upper extremity functional recovery and speech recovery in acute stroke patients and to predict the recovery of upper extremity functions based on recovery of speech. Twenty-eight eligible and willing subjects diagnosed with dominant hemisphere supratentorial stroke were taken for the study. The objectives were achieved with Fugl- Meyer assessment: upper extremity (FMA-UL), Western Aphasia Battery (WAB) scale and Wolf motor function scales (WMFT), that were administered by the tester on the eligible subjects within a week after acute stroke and follow up measurements were carried out post one month. A moderate positive correlation was found in between WMFT and WAB. Strength component of WMFT was found to show better correlation with WAB as compared to functional ability and time components. Since initial recovery is mostly seen within (90-120) days, a long term follow up of the same study may provide more information regarding return of upper extremity function with respect to speech. Hence, recovery of speech can predict upper extremity functional recovery.

Drone Detection and Localization Using Enhanced Fiber-Optic Acoustic Sensor and Distributed Acoustic Sensing Technology

In recent years, the widespread use of drones has led to serious concerns about safety and privacy. Drone detection using microphone arrays has proven to be a promising method. However, it is challenging for microphones to serve large-scale applications due to the issues of synchronization, complexity, and data management. Moreover, distributed acoustic sensing (DAS) using optical fibers has demonstrated its advantages in monitoring vibrations over long distances but does not have the necessary sensitivity for weak airborne acoustics. In this work, we present, to the best of our knowledge, the first fiber-optic quasi-distributed acoustic sensing demonstration for drone surveillance. We develop enhanced fiber-optic acoustic sensors (FOASs) for DAS to detect drone sound. The FOAS shows an ultra-high measured sensitivity of −101.21 re. 1rad/μPa, as well as the capability for high-fidelity speech recovery. A single DAS can interrogate a series of FOASs over a long distance via optical fiber, enabling intrinsic synchronization and centralized signal processing. We demonstrate the field test of drone detection and localization by concatenating four FOASs as a sensing array and capturing the airborne sound remotely through DAS. Both the waveforms and spectral features of the drone sound are recognized. With acoustic field mapping and data fusion, accurate drone localization is achieved with a root-mean-square error (RMSE) of 1.47 degrees. This approach holds great potential in large-scale sound detection applications, such as drone detection or city event monitoring.

COS-Speech: protocol to develop a core outcome set for dysarthria after stroke for use in clinical practice and research

BackgroundDysarthria after stroke is when speech intelligibility is impaired, and this occurs in half of all stroke survivors. Dysarthria often leads to social isolation, poor psychological well-being and can prevent return to work and social lives. Currently, a variety of outcome measures are used in clinical research and practice when monitoring recovery for people who have dysarthria. When research studies use different measures, it is impossible to compare results from trials and delays our understanding of effective clinical treatments. The aim of this study is to develop a core outcome set (COS) to agree what aspects of speech recovery should be measured for dysarthria after stroke (COS-Speech) in research and clinical practice.MethodsThe COS-Speech study will include five steps: (1) development of a long list of possible outcome domains of speech that should be measured to guide the survey; (2) recruitment to the COS-Speech study of three key stakeholder groups in the UK and Australia: stroke survivors, communication researchers and speech and language therapists/pathologists; (3) two rounds of the Delphi survey process; (4) a consensus meeting to agree the speech outcomes to be measured and a follow-up consensus meeting to match existing instruments/measures (from parallel systematic review) to the agreed COS-Speech; (5) dissemination of COS-Speech.DiscussionThere is currently no COS for dysarthria after stroke for research trials or clinical practice. The findings from this research study will be a minimum COS, for use in all dysarthria research studies and clinical practice looking at post-stroke recovery of speech. These findings will be widely disseminated using professional and patient networks, research and clinical forums as well as using a variety of academic papers, videos, accessible writing such as blogs and links on social media.Trial registrationCOS-Speech is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database, October 2021 https://www.comet-initiative.org/Studies/Details/1959.In addition, “A systematic review of the psychometric properties and clinical utility of instruments measuring dysarthria after stroke” will inform the consensus meeting to match measures to COS-Speech. The protocol for the systematic reviews registered with the International Prospective Register of Systematic Reviews. PROSPERO registration number: CRD42022302998.

Neurodynamic speech disorders in the acute ischemic stroke

To identify the features of the clinical picture and evaluate the dynamics of regression of neurodynamic speech disorders in comparison with cortical aphasia in patients with ischemic stroke (IS) in the carotid system. We examined 268 patients with a median age of 59 (54; 70) years in the acute period of IS in the dominant hemisphere with the presence of cortical aphasia or neurodynamic speech disorders. The degree of speech recovery was characterized by an increase in the score on the Speech Questionnaire (ΔSQ) from 1 to 21 days after the development of IS. The patients were divided into group 1 (n=148) with a low level of recovery (ΔSQ≤6) and group 2 (n=120) with a high level (ΔSQ >6). Of the 268 patients, cortical aphasia was detected in 171 (63.8%) patients, and neurodynamic speech disorders characterized by significant variability of symptoms over the course of hours and days were detected in 97 (36.2%) patients. In patients with cortical aphasia, the majority of patients (63.2%) were classified into group 1, and among patients with neurodynamic speech disorders - into group 2 (58.8%), which showed the stability of the regression dynamics of speech disorders (p=0.001). In patients with cortical lesions the impressive side of speech suffered more often - in this group patients with sensorimotor aphasia predominate. In the case of neurodynamic speech disorders, motor and sensorimotor disorders are observed with approximately the same frequency (p=0.002). In comparison with cortical aphasias, the sensory component of speech suffers to a lesser extent in neurodynamic speech disorders. Neurodynamic speech disorders generally recover faster and more fully.

Языковая биография индивида как инструмент моделирования ментального лексикона (на материале экспериментальной работы с пациентами с афазией)

The article considers the relationship between the language biography of a patient with aphasia and the process of her speech rehabilitation. The research project focuses on the problem of predicting the structure of mental lexicon in patients with aphasia via modeling it in native speakers from the same socio-professional groups without speech disorders. The process is largely based on knowledge about common characteristics of their language biography. The aim of the article is to feature the methodology used in such a type of predictive modeling, its theoretical foundations and main advantages for speech rehabilitation work. The research data include: statistics about sociological characteristics of patients collected at the local Neurorehabilitation Center from 2014 to 2018; 18 questionnaires filled in by the relatives of the patients in question; interviews with healthy Russian native speakers, whose socio-professional characteristics are similar to characteristics of one of the target groups of the patients; 12 hours of audio recordings of interviews with healthy native speakers of the Russian language, whose language biography, gender and age characteristics are similar to those of the target groups of the patients; a corpus of interview scripts processed with the Sketch Engine corpus manager; 14 patients’ speech assessment sheets completed in accordance with the Wasserman scale (it is designed to determine speech disorders of patients with a local cerebrovascular accident). By using an interdisciplinary complex of methods we obtained the following results: completed a sociolinguistic portrait of people at risk of aphasia with similar language biographies; listed the most frequent words, collocations and automated verbal series (phrases and sayings) specific to people at risk of aphasia; identified the language biography features that affect mental lexicon; elaborated a complex of exercises for speech rehabilitation of patients with aphasia regarding the specificity of their language biography; validated and assessed the exercises’ effectiveness in clinical practice. Our main conclusion is that the proposed method can help to design for patients with aphasia a more personalized complex of speech recovery exercises that will be adapted to their language biography

Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke.

The cerebral substrates of apraxia of speech (AOS) recovery remain unclear. Resting state fMRI post stroke can inform on altered functional connectivity (FC) within cortical language networks. Some initial studies report reduced FC between bilateral premotor cortices in patients with AOS, with lowest FC in patients with the most severe AOS. However, longitudinal FC studies in stroke are lacking. The aims of the present longitudinal study in early post stroke patients with AOS were (i) to compare connectivity strength in AOS patients to that in left hemisphere (LH) lesioned stroke patients without a speech-language impairment, (ii) to investigate the relation between FC and severity of AOS, aphasia and non-verbal oral apraxia (NVOA) and (iii) to investigate longitudinal changes in FC, from the subacute phase to the chronic phase to identify predictors of AOS recovery. Functional connectivity measures and comprehensive speech-language assessments were obtained at 4 weeks and 6 months after stroke in nine patients with AOS after a LH stroke and in six LH lesioned stroke patients without speech-language impairment. Functional connectivity was investigated in a network for speech production: inferior frontal gyrus (IFG), anterior insula (aINS), and ventral premotor cortex (vPMC), all bilaterally to investigate signs of adaptive or maladaptive changes in both hemispheres. Interhemispheric vPMC connectivity was significantly reduced in patients with AOS compared to LH lesioned patients without speech-language impairment. At 6 months, the AOS severity was associated with interhemispheric aINS and vPMC connectivity. Longitudinal changes in FC were found in individuals, whereas no significant longitudinal change in FC was found at the group level. Degree of longitudinal AOS recovery was strongly associated with interhemispheric IFG connectivity strength at 4 weeks. Early interhemispheric IFG connectivity may be a strong predictor of AOS recovery. The results support the importance of interhemispheric vPMC connection in speech motor planning and severity of AOS and suggest that also bilateral aINS connectivity may have an impact on AOS severity. These findings need to be validated in larger cohorts.